Are Breastfed Babies Smarter?

From flashcards to DVDs, the list of products touted as baby brain boosters is ever-growing. But new research that suggests breastfeeding can significantly improve academic achievement later in life is offering food for thought on the impact of neonatal nutrition.

The benefits of breastfeeding for newborns and new moms alike are many. According to the American Academy of Pediatrics, breast milk is loaded with nutrients that help babies grow and antibodies that stave off infections. Breastfeeding is also thought to protect against chronic diseases such as diabetes (type 1 and 2), obesity and asthma and may even ward off certain cancers such as leukemia.

Breastfeeding moms also tend to recover from their deliveries faster, shed their pregnancy weight sooner and have a decreased risk of breast and ovarian cancer.

Because of the perks for moms and tots, the World Health Organization recommends breastfeeding exclusively for the first six months of life, and continuing to age two or beyond with appropriate complementary foods.

But can breastfeeding actually make babies smarter?

According to the results of an Australian study published in Pediatrics, children who were breastfed for six months or more outscored their formula-fed classmates in tests of reading, writing and math at age 10. However, the benefits were gender-specific, with only boys achieving significantly higher test scores for reasons that remain unclear.

"Our results suggest that breastfeeding duration is independently associated with better educational outcomes in middle childhood, especially for boys," reported Wendy H. Oddy, associate professor at the Telethon Institute for Child Health Research and University of Western Australia, and colleagues.

Several studies have previously linked breastfeeding to later intelligence. But how breastfeeding confers its brainy benefits remains unclear. Researchers suspect that components of breast milk that may be missing from formula, such as the omega-3 fatty acid docosahexaenoic acid (DHA) and the long-chain polyunsaturated fatty acid arachidonic acid (ARA), are essential for optimal brain growth.

Breastfeeding-Brain Link Unclear

Since 2001, when the FDA deemed safe the addition of DHA and ARA to infant formula, manufacturers such as Mead Johnson have been supplementing their products with the fatty acids to make them more like breast milk. But the scientific evidence for doing so is mixed. While some studies suggest including these fatty acids in formula may have positive effects brain development, others have failed to confirm the benefits.

Similarly, studies comparing the later intelligence of preterm babies fed formula or donor breast milk have generated conflicting results. According to a 2007 Cochrane Database Systemic Review, which tallies the current scientific data, there was no evidence that preterm infants fed donor milk had long-term neurodevelopmental advantages over those fed formula. The review authors suggested more properly designed trials are needed.

Teasing out the biological basis for heightened intelligence among breastfed babies is no easy feat. At the core is the complex problem of nature versus nurture – is it the milk itself or the act of breastfeeding? Or, is it some unrelated factor more common among breastfed infants?

Although Oddy and colleagues controlled for variables such as socioeconomic status, maternal education and early cognitive stimulation for babies such as being read to, they did not account for parental intelligence, parenting style or other factors that can influence breastfeeding duration, such as maternity leave and other social support systems.

"While breastfeeding can be an important part of your tool kit to attempt to ensure health and wellbeing of your child, there are so many other pieces of the tool kit," said Dr. Rahil Briggs, assistant professor of pediatrics at Albert Einstein College of Medicine and director of the Healthy Steps Program at Montefiore. A healthy pregnancy, a strong parent-child relationship and a stimulating environment are among other important tools, Briggs said.

Briggs thinks the study gives women one more reason to breastfeed if they can, but stressed that several factors contribute to how children learn and grow in the hands of their parents.

President of the New York Lactation Consultant Association, Susan Burger, PhD, hopes the increasing evidence for the benefits of breastfeeding will translate into more support for new moms, many of whom struggle with learning to breastfeed and keeping it up after returning to work.

"I think it's great that there's another one of these studies," said Burger. "But all the studies in the world aren't going to help if women can't get support."